REQUEST FOR INSPECTION

Client : Pertamina Hulu Rokan SPK.No :-

Project : Pematang Power System Upgrade Location : Batching Plan Harry Beton

Contr No : SPHR00534A Jl Lintas Duri-Dumai km 11

Discipline : CIVIL √ MECH INSTR

PIPING ELECT COATING

Date to Inspect : 15-May-24 Time: 09.00 WIB TYPE OF INSPECTION

Joint Survey

INSPECTION ITEM:
Trial Job Mix Formula (JMF) Job Mix & Site Mix Material Inspection

Beton fc' = 27,5 Mpa & fc' = 13,8 Mpa

√ Witness of testing

Any report will be submitted after ward Release Hold Point

Type of report : ( Tick as many as required )
Walk Thru

Only this report Drawing Punch List

Inspection Report Survey Report Final Inspection

√ Testing Report Other Other Visual Inspection

Remarks :

RESULT / CONCLUSION ( BY PT TPE )

A Test / Inspection result satisfactory D Approved & Procees for next work

B Test / Inspection result Unsatisfactory E Approved with remark

C Required Re - work and or Re -Testing F

If result is B or C or E , Please put the note below

Prepare by : Checked & Reviewed by :

JPK.TPE - QA/QC

BAGUS. K
Date : 14/05/2024 Date :